By Amy Norton
HealthDay reporter
THURSDAY, March 4, 2021 (HealthDay News) – According to a new study, many Hispanic Americans suffer from uncontrolled diabetes, high blood pressure, or other medical conditions that increase the risk of recurrence even after having had a stroke.
The study included 404 Hispanic adults with a history of stroke, or “mini-stroke,” which is a brief decrease in blood flow to the brain that can predict a full stroke. The researchers found that despite this fear, few patients had their stroke risk factors under control.
Awareness didn’t seem to be the problem: most patients with high blood pressure, high cholesterol, or diabetes knew it.
Still, many did not have these conditions under good control, the study found.
“This shows that we still have a lot to do,” said lead researcher Dr. Fernando Testai, Associate Professor of Neurology at the University of Illinois at Chicago. “It’s a wake-up call to the medical community.”
The study, published online March 4 in the journal Stroke, is not the first to reveal a high prevalence of risk for heart and blood vessel disease in Hispanic Americans.
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According to the American Heart Association, more than half of Hispanic men and approximately 43% of Hispanic women in the United States have some form of cardiovascular disease.
The new study focused on a group of patients who ideally should have strict control over conditions such as high blood pressure and diabetes based on their history of stroke.
But this was not the case.
“We found that less than half of the patients who knew they had high blood pressure got their numbers where we wanted them,” Testai said.
By now, only a third of those with known high cholesterol had lowered those numbers, the results showed. And of the patients who knew they had diabetes, just over half had the condition under good control.
The exact reasons are unclear. However, many patients did not receive standard medication: about half received anticoagulant drugs; Cholesterol-lowering statins were given even fewer.
Testai pointed out some broad patterns that emerged in the study.
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The older the patients, the less likely they were to have their high blood pressure or diabetes under control. This could indicate problems with drug adherence or lifestyle recommendations, Testai speculated, or possibly poorer health care compared to younger patients.
In addition, patients who lived in the United States for extended periods of time tended to have poorer diabetes control.
One possible explanation is that these patients were more exposed to the typical U.S. diet and its abundance of calories from processed foods, Testai said.
Dr. José Biller, professor of neurology at Loyola University Chicago, agreed.
“Dietary changes are often attributed to acculturation, and food is often used as a metaphor for citizenship,” said Biller, who is also a volunteer expert with the American Heart Association / American Stroke Association. “We are what we eat. Everyone benefits from a reduced salt consumption, stays active and maintains a healthy lifestyle.”
Biller also said that patients may face “critical” obstacles that make it difficult to stick to medication, ranging from cost, co-existing medical conditions, to their own ideas about the medication.
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In some cases, Testai said, language can be an obstacle. Having doctors to communicate through a translator can make it difficult for them to form a solid relationship between the provider and the patient, he explained.
Communication is key, agreed Biller. He added that healthcare providers need “cultural literacy” and the ability to “actively listen and not speak to patients”.
In a broader sense, Biller said, people who live in communities that are “health deserts” need better access to quality care.
What Patients Can Do, Testai emphasized diet changes, exercise and, if necessary, weight loss.
“Medicines are only part of the story,” he said. “It’s the sedentary lifestyle. It’s the diet.”
Testai pointed out that people don’t need a gym membership to exercise. It comes down to being physically active throughout the day.
“Go out and go around the block,” he said. “Take the stairs instead of the elevator. It’s about changing your entire lifestyle.”
More information
The American Stroke Association has more about stroke prevention.
SOURCES: Dr. med. Fernando Testai, Associate Professor of Neurology at the University of Illinois at Chicago; José Biller, MD, Professor and Chairman, Neurology, Loyola University Chicago, Stritch School of Medicine, Maywood, Illinois, and Volunteer Expert, American Heart Association / American Stroke Association, Dallas; Stroke, March 4, 2021, online
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